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991.
C Cote M D Zilberberg S H Mody L J Dordelly B Celli 《The European respiratory journal》2007,29(5):923-929
Haemoglobin (Hb) abnormalities in chronic obstructive pulmonary disease (COPD) are not well characterised. The present authors investigated the prevalence and association of abnormal Hb with clinical outcomes. Analysis of a prospective cohort of stable COPD outpatients (n = 683) in a USA Veterans Administration pulmonary clinic was undertaken. Patients were classified as anaemic (Hb <13 g.dL(-1)), polycythemic (Hb > or =17 g.dL(-1) and > or =15 g.dL(-1) for males and females, respectively) or normal. Demographic characteristics and physiological/functional outcomes were compared between groups. Regression models adjusting for confounders examined the independent association of anaemia with clinical outcomes. Anaemia was present in 116 (17%) patients and polycythemia in 40 (6%). While the only values that differed between polycythemic and nonpolycythemic patients were mean body mass index and Hb, anaemic patients showed a significantly higher modified Medical Research Council dyspnoea scale score (2.8 versus 2.6), lower 6-min walk distance (265 versus 325 m) and shorter median survival (49 versus 74 months) than nonanaemic patients. In regression models, anaemia independently predicted dyspnoea and reduced exercise capacity. Anaemia in chronic obstructive pulmonary disease was an independent risk factor for reduced functional capacity. Polycythemia prevalence was low and had no association with worsened outcomes. Further work is required to evaluate the effect of anaemia correction on outcomes in chronic obstructive pulmonary disease. 相似文献
992.
Hillary R Bogner Mark S Cary Martha L Bruce Charles F Reynolds Benoit Mulsant Thomas Ten Have George S Alexopoulos 《The American journal of geriatric psychiatry》2005,13(10):861-868
OBJECTIVE: The authors described the influence of specific medical conditions on clinical remission and response of major depression (MDD) in a clinical trial evaluating a care-management intervention among older primary-care patients. METHODS: Adults age 60 years and older were randomly selected and screened for depression. Participants were randomly assigned to Usual Care or to an Intervention with a depression care-manager offering algorithm-based care for MDD. In all, 324 adults meeting criteria for MDD were included in these analyses. Remission and response was defined by a score on the Hamilton Rating Scale for Depression <10 and by a decrease from baseline of > or =50%, respectively. Medical comorbidity was ascertained through self-report. Cognitive impairment was defined by a score <24 on the Mini-Mental State Exam (MMSE). RESULTS: In Usual Care, rates of remission were faster in persons who reported atrial fibrillation (AF) than in persons who did not report AF and slower in persons who reported chronic pulmonary disease than in persons who did not report chronic pulmonary disease; rates of response were less stable in persons with MMSE <24 than in those with MMSE > or =24. In the Intervention condition, none of the specific chronic medical conditions were significantly associated with outcomes for MDD. CONCLUSIONS: Because disease-specific findings were observed in persons who received Usual Care but not in persons who received more intensive treatment in the Intervention condition, our results suggest that the association of medical comorbidity and treatment outcomes for MDD may be determined by the intensity of treatment for depression. 相似文献
993.
A 50-yr-old man presented with synovitis of the metacarpophalangealjoints, Raynaud's phenomenon, recurrent pericarditis and a linearpalpable rash in both axillae. 相似文献
994.
995.
996.
R. Sørensen M. Gadjeva S. Thiel & J. C. Jensenius 《Scandinavian journal of immunology》2004,59(6):626-626
Chronic hepatitis B virus (HBV) infection affects about 200–400 million people worldwide and represents one of the leading causes for liver cirrhosis and hepatocellular carcinoma. Control over the HBV infection is achieved mainly by vaccination with Hepatitis B surface antigen (HBsAg). HBsAg contains N -linked glycosylation side and is recognized by both MBL-A and MBL-C in a Ca-dependent manner. HbsAg–MBL complexes activate complement and may thus affect humoural immunity. To investigate the role of MBL in humoural responses to HBsAg, we immununized mice that lack both MBL-A and MBL-C proteins with soluble HBsAg. It has been shown that deficiencies in other complement components like C1q, C4 and C3 result in decreased antibody responses. However, MBL double KO animals mounted dramatically increased humoural responses. After priming, MBL double KOs mounted HbsAg-specific IgM responses, which were threefold higher than WT controls. After boosting the HBsAg, total IgG was 10-fold higher in MBL KO than in WT control animals. Similar to the response to HbsAg, other glycosylated soluble antigens (e.g. invertase) induced better humoural responses in MBL double KO animals, suggesting that MBL plays an important role in a negative feedback regulation of adaptive immunity. Reconstitution experiments with rMBL partially rescued the KO phenotype. We propose that the clearance of glycoprotein antigens in MBL KO is handled differently from the WT, resulting in better stimulation of humoural responses. Alternatively, glycoprotein-Ag-MBL-rich complexes inhibit B-cell responsiveness via putative MBL receptors. 相似文献
997.
Experimental hyperthyreosis was stimulated by intraventricular injections of sodium solithyroxin (T4) suspension on 1% starch gel during 10 days at a dose of 10 microg/100 g of body mass (n = 15) or 20 microg/100 g of body mass (n = 15). Renal function was tested by 5 % water loading after 24 hrs. since the last T4 injection. Urine and blood plasma samples were analyzed for creatinine; in addition, urine was analyzed for sodium and potassium ions of titrated acids, ammonium cations, and pH. Thyroxin was found to decrease creatinine clearance and expedite renal excretion of sodium and potassium ions irrespective of the amount of exogenous T4; at the same time, exaggerated excretion of titrated acids and ammonium cations correlated with T4 dose. 相似文献
998.
999.
1000.
N. S. Kalson C. P. Charalambous E. S. Powell A. Hearnden J. K. Stanley 《Hand (New York, N.Y.)》2009,4(3):279-282
A common distal radio-ulnar joint (DRUJ) stabilisation procedure uses a tendon graft running from the lip of the radial sigmoid
notch to the ulnar fovea and through a bony tunnel to the ulnar shaft, before being wrapped round the distal ulna and sutured
to itself. Such graft fixation can be challenging and requires a considerable tendon length. The graft length could be reduced
by fixing the graft to the ulna using a bone anchor or interference screw. The aim of this study was to compare the strength
of three distal ulna graft fixation methods (tendon wrapping and suturing, bone anchor and interference screw). Four human
cadaveric ulnae were used. A tendon strip was run through a tunnel in the distal ulna and secured by: (1) wrapping round the
shaft and suturing it to itself, (2) a bone anchor and (3) an interference screw in the bone tunnel. Load to failure was determined
using a custom-made apparatus and an Instron machine. Maximum failure load was highest for the bone anchor fixation (99.3 ± 23.7 N)
followed by the suturing (96.2 ± 12.1 N), and the interference screw fixation (46.9 ± 5.6 N). There was no significant difference
between the tendon suturing and bone anchor methods, but the tendon suturing was statistically significantly higher compared
to the interference screw (P = 0.028). In performing anatomical stabilisation of the DRUJ fixation of the tendon graft to the distal ulna with a bone
anchor provides the most secure fixation. This may make the stabilisation technique less demanding and require a smaller tendon
graft. 相似文献